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Power of Suggestion Shown in Study of Migraine Drug

Expectation plays important role in response to treatment, expert says

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When Maxalt was labeled "Maxalt," the patients' reports of pain relief more than doubled compared to when Maxalt was labeled "placebo," said Kaptchuk, a professor of medicine at Harvard. "This tells us that the effectiveness of a good pharmaceutical may be doubled by enhancing the placebo effect," he said.

When patients received Maxalt labeled as placebo, they were being treated by the medication but without any positive expectation, the other senior author, Rami Burstein, a professor of medicine at Harvard, said in a Beth Israel news release. "This was an attempt to isolate the pharmaceutical effect of Maxalt from any placebo effect," Burstein said.

The authors were surprised to find that even when patients were given a placebo labeled as "placebo," they reported pain relief, compared with no treatment.

"We don't know what that's about. It's a novel finding," added Kaptchuk.

Charles said the study was interesting and confirms what many experts believe about the placebo effect. "It's more rigorous than perhaps a number of the other studies that have been done previously," he noted.

Could these results play out across the spectrum of medical care?

"Obviously we don't know, we only looked at migraine," said Kaptchuk, "but I think that in many categories of illness and drugs, this would be proof of concept.

"This is likely to be operating in many other conditions, especially in conditions like nausea or irritable bowel syndrome, where a person's illness is defined by self-report," he added. "Self-reporting is a big part of what people feel."

More research will be needed to explore how these findings could be applied to clinical care and to learn more about how placebos might help boost drug treatment care, Kaptchuk said.

Some research has suggested that simply hearing the words of medicine can have a healing effect, he noted.

The study was partly funded by Merck and Co., the maker of Maxalt.

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